Patellar luxation in big dog.

Dr. Marie replied:

Oh man. It's starting to look like Max is a bit of a lemon. It's a good thing he's such an awesome dog other than his health!

It's a little bit unusual to see a luxating patella in a large dog. I will commonly feel them on dogs like yorkies or pugs.

Usually, if I feel one on a large dog it is the result of some type of accident. However, in these cases, there usually is some sort of sign of discomfort. It doesn't sound like Max has any discomfort at all.

If I feel a luxating patella on a dog that has no signs of discomfort then I usually give my clients a couple of options.

The first is to just keep an eye on things for the next few weeks. I have had some dogs where the patella firms up again and stays in place.

The next option is to have a specialist take a look. The specialist can tell us a little bit more about how serious of a problem this is. He or she can tell us about if there is a problem with the groove that the patella sits in (i.e. not deep enough) or if there has been damage to the ligaments that keep the patella in place.

Then, the next question is what to do about it. Ideally, if it doesn't resolve on its own within a few weeks then surgery is recommended. There are several different things that the surgeon can do to ensure that the patella stays in place and doesn't cause further problems. It is a surgery that dogs tend to handle well. But it can be pricey (i.e. $1500-$3000).

Then there are other dogs where we do nothing. I find it is often difficult to convince an owner to spend that kind of money on a surgery when the dog is not showing any lameness or obvious pain issues. If we do nothing, though, then it is possible that this joint can develop severe arthritis as the dog gets older. If you are at all thinking of doing surgery, then it is best to have it done before there is any damage to the joint. With that being said, I have had patients that have had patellar luxation for their whole lives and have not ended up with any known arthritis issues.

It really is a tough call!

To recap...I would likely wait it out a few weeks and see if the problem is still there. If so, it doesn't hurt to see a specialist. I have found that orthopedic specialists tend to be very honest. If they don't feel that surgery is going to help then they will not recommend going ahead with it.

I hope that helps and I hope Max's UTI clears up quickly!

Dr. Marie.


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Dr. Marie replied:

Interesting. I wonder if the patella has always been like that or if this is a new thing. I'm guessing this is new as most likely the vet has palpated his knees before.

I still think it's possible that he has pulled/stretched something and will end up ok in a few weeks.

My experiences with patella surgeries have all been on little dogs that I can recall. Almost all of them run really well on three legs for anywhere from a few days to about 2 weeks and then start putting weight on. Usually by 8 weeks they are completely normal. It is possible that it takes a bit longer for a big dog to recover.

I think the first step, if this doesn't heal on its own, is to have a good talk with the specialist. They will be very honest with you about the average recovery time from surgery and tell you what to expect. And, again, if they don't feel surgery is necessary they may just not do it, or they may put it off for some time to see what Max's body does on its own.

Dr. Marie replied:

I don't like hearing that there may be hip dysplasia. Did they give you any sense of how bad the dysplasia is? Or maybe they're waiting for the specialist to comment first.

If a dog has hip dysplasia then it causes the femur to not sit properly in the joint. This will cause Max to carry his leg slightly differently. It's possible that the strain of carrying his leg in a less natural position has affected his patella.

It's going to be a tough call here on what to do. The specialist will be able to give you the best advice. If necessary, there are surgeries that can repair the hip joint. They really vary in technique and cost. Then, once the hip is repaired they will see if the patella needs to have surgery.

It's possible as well that the specialist may say that the hip issue is mild and may just focus on the patella.

I really hope you get ok news from the specialist.